HESI RN
HESI Pharmacology Exam 2 Questions
Extract:
Question 1 of 5
A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
Correct Answer: C
Rationale: Involuntary movements (extrapyramidal symptoms) are a serious, potentially irreversible side effect of metoclopramide due to dopamine receptor blockade. Reporting these promptly allows intervention, such as dose adjustment or anticholinergic use. Nausea, diarrhea, and irritability are less urgent side effects.
Question 2 of 5
The nurse is administering the muscle relaxant baclofen by mouth (PO) to a client diagnosed with multiple sclerosis. Which intervention should the nurse implement?
Correct Answer: A
Rationale: Baclofen can cause dizziness or orthostatic hypotension, increasing fall risk in clients with multiple sclerosis, who may already have impaired coordination. Advising slow, cautious movement when rising and walking is the most critical intervention to prevent falls. Monitoring intake/output or muscle strength is not directly related to baclofen’s side effects, and abrupt discontinuation risks withdrawal.
Extract:
History and Physical
The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.
Orders
• prescription of captopril 25mg by mouth twice a day
Laboratory Test
Hemoglobin A1C:
• Result- 6.8%
• Reference Range- 4 to 5.9%
Question 3 of 5
For each instruction, click to indicate whether the instructions given by the nurse are indicated or contraindicated to prepare for the client’s first dose of captopril.
| Options | Indicated | Contraindicated |
|---|---|---|
| Increase the lantus dose by 3 units the morning of the first dose. | ||
| Limit fluids for several days before the first dose. | ||
| Hold spironolactone for 3 days. | ||
| Lay down if the blood pressure drops quickly after the first dose. | ||
| Monitor blood pressure for several hours after the first dose. |
Correct Answer:
Rationale: Holding spironolactone reduces hyperkalemia risk with captopril, lying down manages hypotension, and monitoring blood pressure ensures safety. Increasing insulin or limiting fluids lacks rationale and risks hypoglycemia or dehydration.
Extract:
Question 4 of 5
A client with chemotherapy-induced nausea receives a prescription for metoclopramide. Which adverse effect is most important for the nurse to report?
Correct Answer: C
Rationale: Involuntary movements (extrapyramidal symptoms) are a serious, potentially irreversible side effect of metoclopramide due to dopamine receptor blockade. Reporting these promptly allows intervention, such as dose adjustment or anticholinergic use. Nausea, diarrhea, and irritability are less urgent side effects.
Question 5 of 5
Prior to administering oral doses of calcitriol and calcium carbonate to a client with hypoparathyroidism, the nurse notes that the client’s total calcium level is 14 mg/dL (3.5 mmol/L). Which action should the nurse implement? Reference Range: Total Calcium [Reference Range: Adult 9 to 10.5 mg/dL or 2.25 to 2.62 mmol/L]
Correct Answer: B
Rationale: A calcium level of 14 mg/dL indicates hypercalcemia, risking complications like arrhythmias. Holding both calcitriol and calcium carbonate and contacting the provider prevents further calcium elevation. Administering either medication could worsen hypercalcemia, making holding both the safest action.